Executive functioning of complicated-mild to moderate traumatic brain injury patients with frontal contusions.

Executive dysfunctions are among the most prevalent neurobehavioral sequelae of traumatic brain injuries (TBIs). Using culturally validated tests from the Delis-Kaplan Executive Function System (D-KEFS: Trail Making, Verbal Fluency, Design Fluency, Sorting, Twenty Questions, and Tower) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS: Rule Shift Cards, Key Search, and Modified Six Elements), the current study was the first to examine executive functioning in a group of Iranian TBI patients with focal frontal contusions. Compared with a demographically matched normative sample, the frontal contusion patients showed substantial impairments, with very large effect sizes (p ≤ .003, 1.56 < d < 3.12), on all the executive measures. Controlling for respective lower-level/fundamental conditions, the differences on the highest-level executive (cognitive switching) conditions were still significant. The frontal patients also committed more errors. Patients with lateral prefrontal (LPFC) contusions were qualitatively worst. For example, only the LPFC patients committed perseverative repetition errors. Altogether, our results support the notion that the frontal lobes, specifically the lateral prefrontal regions, play a critical role in cognitive executive functioning, over and above the contributions of respective lower-level cognitive abilities. The results provide clinical evidence for validity of the cross-culturally adapted versions of the tests.

Cross-Cultural adaptation of executive function tests for assessments of traumatic brain injury patients in southeast Iran / Adaptación transcultural de tests de la función ejecutiva para la evaluación de pacientes con lesiones cerebrales traumáticas en el sudeste de Irán

The Delis-Kaplan Executive Function System (D-KEFS) is a "greatest hits" collection of commonly used tests of executive functioning. We mainly aimed to develop a Persian version of D-KEFS for brain-damaged patients in Zahedan, Iran, and to provide preliminary validation evidence, applying a normal sample with demographic traits of the patients. In the judgmental phase, we conducted several local field studies and non-standard pilot administrations, and accordingly we made various cross-cultural adaptations. For the statistical phase, the provided materials along with four tests from the Behavioral Assessment of the Dysexecutive Syndrome (BADS) were administered to 75 healthy individuals. Within 12 to 30 days, 24 subjects were retested. Relatively high reliabilities were obtained for most of the D-KEFS measures. In validity analysis, strong correlations were found among the majority of the scores within the tests; correlations between various D-KEFS tests were in the range of weak to moderate; and significant correlations were found between the majority of D-KEFS executive scores and BADS scores. In conclusion, the adapted tests show acceptable psychometric properties in assessing the complex, multidimensional construct of executive functioning

El "Sistema Delis-Kaplan de la función ejecutiva" (Delis-Kaplan Executive Function System; D-KEFS) es una colección de "grandes éxitos" de tests utilizados para la evaluación del funcionamiento ejecutivo. Nuestro objetivo principal fue desarrollar una versión persa del D-KEFS para pacientes con dano cerebral en Zahedan, Iran, y proporcionar pruebas preliminares de su validación al aplicarlo a una muestra de pacientes locales. En la fase de evaluación, llevamos a cabo varios estudios de campo y aplicaciones piloto no estandar y, en consonancia, realizamos varias adaptaciones transculturales. En la fase estadística, dichos materiales junto con cuatro tests de la "Evaluación conductual del síndrome disejecutivo" (Behavioral Assessment of the Dysexecutive Syndrome; BADS) se administraron a 75 individuos sanos. Entre 12 y 30 dias despues, se volvio a evaluar (retest) a 24 sujetos. Se obtuvieron fiabilidades relativamente elevadas para la mayoría de las medidas del D-KEFS. En los análisis de validación, se encontraron elevadas correlaciones entre la mayoría de las puntuaciones intratests. Las correlaciones entre varios de los tests del D-KEFS se hallaban en el rango de débiles a moderadas y se encontraron correlaciones significativas entre la mayoría de las puntuaciones ejecutivas del D-KEFS y de la BADS. En conclusión, los tests adaptados muestran propiedades psicométricas aceptables para evaluar el complejo constructo multidimensional del funcionamiento ejecutivo

Frequency of structural brain abnormalities among adult diagnosed with Attention - Deficit/Hyperactivity Disorder.

Although ADHD is known as a childhood disorder, it is prevalent among adults as well. Several studies have been conducted on the etiology of this disorder and its neurobiological and neuroanatomical manifestations in children, but the knowledge of adult ADHD is not enough. The present research was aimed at studying the structural brain abnormalities in adult ADHD cases. Fifteen adult patients diagnosed with ADHD, developed during their childhood, were selected for this study. In addition to clinical interview and Magnetic Resonance Imaging (MRI), all the participants were asked to fill the (ASRS-VI.I). The results indicated that about 40 % of adults with ADHD suffer from structural brain abnormalities. The results of MRI showed that 100% of the individuals with inattentive and combined types of ADHD were structurally damaged but MRI results did not reveal any structural brain abnormalities in hyperactive participants. The results of the present study are somewhat consistent with the results of previous studies. In general, any brain injury in the region related to cognitive processes (such as attention, memorization, and prevention) and brain circuits related to motor functions and motivation can contribute a role to the induction of ADHD symptoms. It is recommended to conduct more researches in the future with larger samples using other methods that are capable of assessing brain performance and the level and mechanism of the functions of neurotransmitters and neuronal modulators.

A study of mental health and dyadic adjustment between smokers and nonsmokers.

BACKGROUND: The mental health and dyadic adjustment of smokers is a matter of serious concern which brings many demerits on mental health as well as physical heath. OBJECTIVES: This study was performed to ascertain the relationship between mental health and dyadic adjustment of smokers and nonsmokers in Zahedan. PATIENTS AND METHODS: The sample size consisted of 100 smokers and 100 nonsmokers selected through accessible sampling method. The General Health Questionnaire-28 (GHQ-28) and Dyadic Adjustment Scale (DAS) were used to collect the data. Pearson correlation, stepwise regression, and independent "t-test" were applied to analyze the data. RESULTS: Results revealed that physical symptoms, anxiety, social dysfunction, and depression sub-scales, as well as total scores of mental health negatively correlated with dyadic adjustment. Stepwise regression showed the following results: in the total sample, physical symptoms accounted for 22.7% of the variance in dyadic adjustment; also in the total sample, physical symptoms and social dysfunction together explained 24.5% of the variance in dyadic adjustment; social dysfunction accounted for 30%, anxiety for 3.7%, depression for 7% and overall mental health for 3.5% of the variance in dyadic adjustment in the smokers' sample. Results demonstrated that physical symptoms explained 15.9% of the variance in dyadic adjustment in the nonsmokers' sample. Results further revealed that the mean scores of physical symptoms and anxiety sub-scales, and the total scores of the mental health of smokers were greater than those of nonsmokers. However, no significant differences appeared between the two groups on social dysfunction and depression. Finally, the research revealed that the mean scores of dyadic adjustment were greater for nonsmokers than for smokers. CONCLUSIONS: The research revealed that nonsmokers showed better mental health and dyadic adjustment than smokers, thus suggesting that smoking endangers and can impair the tranquility of families and that smoking also threatens the dyadic adjustment of couples.

Effectiveness of optimism skills group training: examination of the attributional styles of boys at the kerman juvenile correction and rehabilitation center.

BACKGROUND: The way that people explain events may influence aspects of their development and health. A number of studies have reported that there is a positive relationship between pessimism and the risk of poor heath, infectious disease, and early mortality. OBJECTIVES: This study was conducted to examine the effectiveness of an optimism skills group training (OSGT) on the attribution styles of delinquent boys. PATIENTS AND METHODS: A quasi-experimental method with a two-group design was used, with random assignment and pre- and post-tests. The subjects were selected from adolescent boys, aged 13 to 18 years, in the Kerman Juvenile Correction and Rehabilitation Center (KJCRC). The participants were allocated to two matched groups based on their pre-test scores. They were assigned randomly to the control and experimental groups. The sample comprised 61 boys. Optimism Skills Group Training (OSGT) was conducted with the experimental group during 10 sessions. Then the subjects were administered the post-test, with a follow-up test a month later. Statistical analysis was conducted using the t-test and repeated-measures analysis of variance. The research instrument was the Attributional Style Questionnaire (ASQ). RESULTS: The results showed that the OSGT changed the attributional styles of delinquent boys from pessimistic to optimistic. Also, the follow up study showed that the effect on the delinquent boys' attributional style was still present after one month. CONCLUSIONS: Even though the OSGT is an effective technique for inculcating an optimistic attribution style in delinquent boys, this important method needs to be continually implemented in their education.